Relationship between research activity and the performance of English general practices: cross-sectional and longitudinal analyses

Gibson, Jonathan; Kontopantelis, Evangelos; Sutton, Matthew; Boaz, Annette; Little, Paul; Mallen, Christian D; McManus, Richard; Park, Sophie; Bower, Peter

Abstract

Research activity usually improves outcomes by being translated into practice. However, there is developing evidence that research activity itself may improve the overall performance of health care organisations. However, evidence that these relationships represent a causal impact of research activity is less clear. Additionally, the bulk of the existing evidence relates to hospital settings, and it is not known if those relationships would also be found in general practice, where most patient contacts occur. We sought to (a) test whether there were significant relationships between research activity in general practice and organisational performance (b) test whether those relationships were plausibly causal. We analysed national data between 2008 and 2019 using cross sectional and longitudinal analyses, on general practices in England. We used cross-sectional, panel and instrumental variable analyses to explore relationships between research activity (including measures from the NIHR Clinical Research Network and the Royal College of General Practitioners) and practice performance (including clinical quality of care, patient reported experience of care, prescribing quality and hospital admissions) Results: In cross-sectional analyses, research activity was positively associated with several measures of practice performance, including clinical quality of care, patient reported experience of care, and reduced hospital admissions. The associations were generally modest in magnitude. However, longitudinal analyses did not support a reliable causal relationship. Similar to findings from hospital settings, research activity in general practice is associated with practice performance. There is less evidence that research is causing those improvements, although this may reflect the limited level of research activity in most practices. We identified no negative impacts, suggesting that research activity is a potential marker of quality and something that high quality practices can deliver alongside their core responsibilities. [Abstract copyright: Copyright © 2024, The Authors.]

Citation

Gibson, J., Kontopantelis, E., Sutton, M., Boaz, A., Little, P., Mallen, C. D., …Bower, P. (in press). Relationship between research activity and the performance of English general practices: cross-sectional and longitudinal analyses. British Journal of General Practice (BJGP), BJGP.2024.0111. https://doi.org/10.3399/BJGP.2024.0111

• Journal Article Type: Article
• Acceptance Date: Jun 13, 2024
• Online Publication Date: Jun 27, 2024
• Deposit Date: Aug 9, 2024
• Publicly Available Date: Aug 9, 2024
• Journal: British Journal of General Practice
• Print ISSN: 0960-1643
• Publisher: Royal College of General Practitioners
• Peer Reviewed: Peer Reviewed
• Pages: BJGP.2024.0111
• DOI: https://doi.org/10.3399/BJGP.2024.0111
• Keywords: research activity, general practice, primary care, outcomes, family practice, research on research
• Public URL: https://keele-repository.worktribe.com/output/875554